Bulimia Nervosa (cont.)

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

What are complications of bulimia?

The potential dangers of bulimia can be severe and affect virtually every organ system. The malnutrition that can result from inducing vomiting
and abusing laxatives, diet pills, and/or diuretics (medications that cause increased urinating) can result in low blood pressure to the point of fainting, cold hands and feet, abnormalities in body chemistry (abnormal electrolyte levels), as well as abnormal hormone levels, failure to ovulate, and delayed puberty. Permanent complications can include stunted growth, decreased bone density, and changes in the person's brain structure. Severe complications can include irregular heartbeat and rectal prolapse. People with bulimia tend to have twice the mortality rates as individuals with no eating disorder. Suicide is a significant component of the higher mortality rate.

What is the prognosis for bulimia?

In contrast to illnesses like depression, that can have as much as a 75% recovery rate, only about 45% of people with bulimia fully recover. Most full recovery takes place between four and nine years later. About 27% of bulimia sufferers significantly improve without full recovery, and more than 20% continue to have chronic symptoms or switch to having another eating disorder.

The mortality rate of bulimia, at 0.3%, is many times less than that of
anorexia, which is about 5%. Both of these eating disorders often co-occur with
depressive, anxiety, and other mood disorders, as well as with personality
disorders like borderline personality disorder.